JAN EMMANUEL SERRANO BSN 3-1

CASE STUDY

PLEURAL EFFUSION

A pleural effusion is an unusual amount of fluid around the lung. Many medical conditions
can lead to it, so even though your pleural effusion may have to be drained, your doctor
likely will target the treatment at whatever caused it.
The pleura is a thin membrane that lines the surface of your lungs and the inside of your
chest wall. When you have a pleural effusion, fluid builds up in the space between the
layers of your pleura.
Normally, only teaspoons of watery fluid are in the pleural space, which allows your lungs to
move smoothly in your chest cavity when you breathe.

CAUSES
 Leaking from other organs. This usually happens if you have congestive heart
failure, when your heart doesn't pump blood to your body properly. But it can also
come from liver or kidney disease, when fluid builds up in your body and leaks into
the pleural space.
 Cancer. Usually lung cancer is the problem, but other cancers that have spread to
the lung or pleura can cause it, too.
 Infections. Some illnesses that lead to pleural effusion
are pneumonia or tuberculosis.
 Autoimmune conditions. Lupus or rheumatoid arthritis are some diseases that
can cause it.
 Pulmonary embolism. This is a blockage in an artery in one of your lungs, and it
can lead to pleural effusion.

SYMPTOMS

 Shortness of breath
 Chest pain, especially when breathing in deeply (This is called pleurisyor pleuritic
pain.)
 Fever
 Cough

DIAGNOSIS
 Chest X-ray. Pleural effusions appear white on X-rays, while air space looks
black. If a pleural effusion is likely, you may get more X-ray films while you lie on
your side. These can show if the fluid flows freely within the pleural space.
  Computed tomography (CT scan). A CT scanner takes many X-rays quickly, and
a computer constructs images of the entire chest -- inside and out. CT scans show
more detail than chest X-rays do.
 Ultrasound. A probe on your chest will create images of the inside of your body,
which show up on a video screen. Your doctor may use the ultrasound to locate the
fluid so they can get a sample for analysis.
Also, your doctor might do a procedure called thoracentesis. They'll take a little bit of the
fluid to test. To do this, they insert a needle and a tube called a catheter between your ribs,
into the pleural space.

TYPES
 Transudative. This pleural effusion fluid is similar to the fluid you normally have in
your pleural space. It forms from liquid leaking across normal pleura. This type rarely
needs to be drained unless it's very large. Congestive heart failure is the most
common cause of this type.
 Exudative. This forms from extra liquid, protein, blood, inflammatory cells or
sometimes bacteria that leak across damaged blood vessels into the pleura. You
may need to get it drained, depending on its size and how much inflammation there
is. The causes of this type include pneumonia and lung cancer.

TREATMENT
 Thoracentesis. If the effusion is large, your doctor may take more fluid than she
needs for testing, just to ease your symptoms.
 Tube thoracostomy (chest tube). Your doctor makes a small cut in your chest wall
and puts a plastic tube into your pleural space for several days.
 Pleural drain. If your pleural effusions keep coming back, your doctor may put a
long-term catheter through your skin into the pleural space. You can then drain the
pleural effusion at home. Your doctor will tell you how and when to do that.
 Pleurodesis. Your doctor injects an irritating substance (such as talc or doxycycline)
through a chest tube into the pleural space. The substance inflames the pleura and
chest wall, which then bind tightly to each other as they heal. Pleurodesis can
prevent pleural effusions from coming back in many cases.
 Pleural decortication. Surgeons can operate inside the pleural space, removing
potentially dangerous inflammation and unhealthy tissue. To do this, your surgeon
may make small cuts (thoracoscopy) or a large one (thoracotomy).
 REFLECTION
As what I have observed through my patient, she also
manifests the same signs and symptoms like what is said
about the reference. She is currently receiving
supplemental oxygen to support or facilitate her breathing.
What I have realized about this disease is that it was a
complication or an underlying symptom of some certain
diseases like cancer, which in the case of my patient. She
has acquired recurrent pleural effusion due to invasive
ductal breast carcinoma. It may be caused by the
proximity or distance between the breast and the lungs
where a fluid leak may likely occur. As of now, she is not
receiving any major treatment to this condition; the initial
actions were done by providing her with medications that
could alleviate her suffering.